Scott Michael

Cardiac Autonomic Responses during Exercise and Post-exercise Recovery Using Heart Rate Variability and Systolic Time Intervals—A Review

Cardiac parasympathetic activity may be non-invasively investigated using heart rate variability (HRV), although HRV is not widely accepted to reflect sympathetic activity. Instead, cardiac sympathetic activity may be investigated using systolic time intervals (STI), such as the pre-ejection period. Although these autonomic indices are typically measured during rest, the “reactivity hypothesis” suggests that investigating responses to a stressor (e.g., exercise) may be a valuable monitoring approach in clinical and high-performance settings. However, when interpreting these indices it is important to consider how the exercise dose itself (i.e., intensity, duration, and modality) may influence the response. Therefore, the purpose of this investigation was to review the literature regarding how the exercise dosage influences these autonomic indices during exercise and acute post-exercise recovery. There are substantial methodological variations throughout the literature regarding HRV responses to exercise, in terms of exercise protocols and HRV analysis techniques. Exercise intensity is the primary factor influencing HRV, with a greater intensity eliciting a lower HRV during exercise up to moderate-high intensity, with minimal change observed as intensity is increased further. Post-exercise, a greater preceding intensity is associated with a slower HRV recovery, although the dose-response remains unclear. A longer exercise duration has been reported to elicit a lower HRV only during low-moderate intensity and when accompanied by cardiovascular drift, while a small number of studies have reported conflicting results regarding whether a longer duration delays HRV recovery. “Modality” has been defined multiple ways, with limited evidence suggesting exercise of a greater muscle mass and/or energy expenditure may delay HRV recovery. STI responses during exercise and recovery have seldom been reported, although limited data suggests that intensity is a key determining factor. Concurrent monitoring of HRV and STI may be a valuable non-invasive approach to investigate autonomic stress reactivity; however, this integrative approach has not yet been applied with regards to exercise stressors.

Accuracy in Estimating Repetitions to Failure During Resistance Exercise

Abstract Hackett, DA, Cobley, SP, Davies, TB, Michael, SW, and Halaki, M. Accuracy in estimating repetitions to failure during resistance exercise. J Strength Cond Res 31(8): 2162–2168, 2017—The primary aim of this study was to assess the accuracy in estimation of repetitions to failure (ERF) during resistance exercise. Furthermore, this investigation examined whether the accuracy in ERF was affected by training status, sex, or exercise type. Eighty-one adults (men, n = 53 and women, n = 28) with broad range of resistance training experience participated in this study. Subjects performed up to 10 sets of 10 repetitions at 70% 1 repetition maximum (1RM) and 80% 1RM for the chest press and leg press, respectively. At the completion of each set, subjects reported their ERF and then continued repetitions to failure to determine actual repetitions to failure (ARF). The accuracy (amount of error) of ERF was determined over an ARF 0–10. Significant differences were found for error of ERF among ARF (p < 0.001), with the error of ERF ∼1 repetition at ARF 0–5 compared with >2 repetitions at ARF 7–10. Greater accuracy was found for the chest press compared with leg press, with the error of ERF ⩽1 repetition for ARF 0–5 and ARF 0–3, respectively (p = 0.012). Men were found to be more accurate than women at specific ARFs for the leg press (p = 0.008), whereas no interaction was found for the chest press. Resistance training experience did not affect the accuracy in ERF. These results suggest that resistance trainers can accurately estimate repetitions to failure when close to failure and that ERF could importantly be practically used for prescription and monitoring of resistance exercise.

Higher exercise intensity delays postexercise recovery of impedance-derived cardiac sympathetic activity

Systolic time intervals (STIs) provide noninvasive insights into cardiac sympathetic neural activity (cSNA). As the effect of exercise intensity on postexercise STI recovery is unclear, this study investigated the STI recovery profile after different exercise intensities. Eleven healthy males cycled for 8 min at 3 separate intensities: LOW (40%-45%), MOD (75%-80%), and HIGH (90%-95%) of heart-rate (HR) reserve. Bio-impedance cardiography was used to assess STIs - primarily pre-ejection period (PEP; inversely correlated with cSNA), as well as left ventricular ejection time (LVET) and PEP:LVET - during 10 min seated recovery immediately postexercise. Heart-rate variability (HRV), i.e., natural-logarithm of root mean square of successive differences (Ln-RMSSD), was calculated as an index of cardiac parasympathetic neural activity (cPNA). Higher preceding exercise intensity elicited a slower recovery of HR and Ln-RMSSD (p < 0.001), and these measures did not return to baseline by 10 min following any intensity (p ≤ 0.009). Recovery of STIs was also slower following higher intensity exercise (p ≤ 0.002). By 30 s postexercise, higher preceding intensity resulted in a lower PEP (98 ± 14 ms, 75 ± 6 ms, 66 ± 5 ms for LOW, MOD, and HIGH, respectively, p < 0.001). PEP recovered to baseline (143 ± 11 ms) by 5 min following LOW (139 ± 13 ms, p = 0.590) and by 10 min following MOD (145 ± 17 ms, p = 0.602), but was still suppressed at 10 min following HIGH (123 ± 21 ms, p = 0.012). Higher preceding exercise intensity attenuated the recovery of indices for cSNA (from STIs) and cPNA (from HRV) in a graded dose-response fashion. While exercise intensity must be considered, acute recovery may be a valuable period during which to concurrently monitor these noninvasive indices, to identify potentially abnormal cardiac autonomic responses.

Heart-rate variability threshold as an alternative for spiro-ergometry testing: A validation study

Abstract Mankowski, RT, Michael, S, Rozenberg, R, Stokla, S, Stam, HJ, and Praet, SFE. Heart-rate variability threshold as an alternative for spiro-ergometry testing: a validation study. J Strength Cond Res 31(2): 474–479, 2017—Although spiro-ergometry is the established “gold standard” for determination of the second ventilatory threshold (VT2), it is a costly and rather time-consuming method. Previous studies suggest that assessing the second anaerobic threshold (AT2) on the basis of heart rate variability (HRV) during exercise may be a more cost-effective and noninvasive manner. However, appropriate validation studies, are still lacking. Eleven healthy, moderately trained subjects underwent 3 incremental exercise tests. Ventilation, oxygen uptake (V[Combining Dot Above]O2), CO2 production (V[Combining Dot Above]CO2), and HRV were measured continuously. Exercise testing was performed in 3 oxygen (FiO2) conditions of inspired air (14, 21, and 35% of oxygen). Participants and assessors were blinded to the FiO2 conditions. Two research teams assessed VT2s and HRVT2s independently from each other. Mean workloads corresponding to VT2 and HRVT2 in hypoxia were, respectively, 19 ± 17% (p = 0.01) and 15 ± 15% (p = 0.1) lower in comparison with hyperoxic conditions. Bland-Altman analysis showed low estimation bias (2.2%) and acceptably precise 95% limits of agreement for workload −15.7% to 20.1% for all FiO2 conditions. Bias was the lowest under normoxic conditions (1.1%) in comparison with hypoxia (3.7%) and hyperoxia (4.7%). Heart rate variability–based AT2 assessment had a most acceptable agreement with VT2 under normoxic conditions. This simple HRVT2 assessment may have potential applications for exercise monitoring in commercial fitness settings.

The compatibility of concurrent high intensity interval training and resistance training for muscular strength and hypertrophy: a systematic review and meta-analysis

ABSTRACT The purpose of this systematic review and meta-analysis is to assess the effect of concurrent high intensity interval training (HIIT) and resistance training (RT) on strength and hypertrophy. Five electronic databases were searched using terms related to HIIT, RT, and concurrent training. Effect size (ES), calculated as standardised differences in the means, were used to examine the effect of concurrent HIIT and RT compared to RT alone on muscle strength and hypertrophy. Sub-analyses were performed to assess region-specific strength and hypertrophy, HIIT modality (cycling versus running), and inter-modal rest responses. Compared to RT alone, concurrent HIIT and RT led to similar changes in muscle hypertrophy and upper body strength. Concurrent HIIT and RT resulted in a lower increase in lower body strength compared to RT alone (ES = −0.248, p = 0.049). Sub analyses showed a trend for lower body strength to be negatively affected by cycling HIIT (ES = −0.377, p = 0.074) and not running (ES = −0.176, p = 0.261). Data suggests concurrent HIIT and RT does not negatively impact hypertrophy or upper body strength, and that any possible negative effect on lower body strength may be ameliorated by incorporating running based HIIT and longer inter-modal rest periods.

Make it easier! Evaluation of the ‘vagal-sympathetic effect’ in different conditions with R–R intervals monitoring

We have read with interest the recent study of Esco et al. (2018), in which the authors suggested the use of the shortened ratio of the standard deviation of normal R–R intervals to the root mean square of successive normal R–R interval differences (SDNN/RMSSD) as a valid surrogate of the traditional ratio of the power spectral low frequency–high frequency (LF/HF) bands for evaluating ‘sympathovagal balance’ in athletes before and following maximal exercise. However, we would like to highlight some important aspects that question the validity of the LF/HF and SDNN/ RMSSD ratios as meaningful measures of ‘sympathovagal balance’, and instead suggest the use of a simpler index for this purpose. Firstly, Eckberg (1997) and Billman (2013) have previously explained why the LF/HF ratio should not be considered a valid index of ‘sympathovagal balance’, despite its widespread use. In particular, this interpretation relies on several assumptions that have been shown to be false, namely: (a) sympathetic activity having a major contribution to the LF band; (b) vagal and sympathetic activities always operating in a reciprocal manner; and (c) there existing simple linear interactions between vagal and sympathetic effects on heart rate variability (HRV) (Eckberg 1997; Billman 2013). The classic study by Goldberger (1999) highlighted the need for validating purported autonomic indices as having genuine physiological meaning by demonstrating they behave as expected during selective autonomic stimulation and blockade. This is not the case in the Esco et al. (2018) study, which supports its suggestions based mainly on the high correlations found between the LF/HF and the SDNN/ RMSSD ratios. The second aspect refers to the mathematical association between heart rate and HRV (Sacha 2014). Thus, because of this association and the resting and post-exercise conditions evaluated by Esco et al., the strong correlations observed between SDNN/RMSSD and LF/HF would be expected. This mathematical association may also explain why the study found strong correlations between vagal indices (RMSSD and HF) and indices purportedly having a substantial sympathetic contribution (SDNN and LF). It is important to emphasize that, although current evidence somewhat supports the validity of some HRV indices (RMSSD and HF) for evaluating vagal modulation, there does not appear to be any HRV index that adequately reflects sympathetic modulation or activity (Michael et al. 2017). In this regard, systolic time intervals (particularly the ‘pre-ejection period’) represent an interesting avenue for non-invasive assessment of sympathetic responses to different stressors, including exercise (Michael et al. 2017). Finally, Esco et al. highlighted the need for simple indices for the evaluation of ‘sympathovagal balance’ in the field. Previously, Goldberger (1999) evaluated the validity This comment refers to the article available at https ://doi. org/10.1007/s0042 1-017-3759-x

Influence of exercise modality on cardiac parasympathetic and sympathetic indices during post-exercise recovery

OBJECTIVES This study investigated indirect measures of post-exercise parasympathetic reactivation (using heart-rate-variability, HRV) and sympathetic withdrawal (using systolic-time-intervals, STI) following upper- and lower-body exercise. DESIGN Randomized, counter-balanced, crossover. METHODS 13 males (age 26.4±4.7years) performed maximal arm-cranking (MAX-ARM) and leg-cycling (MAX-LEG). Subsequently, participants undertook separate 8-min bouts of submaximal HR-matched exercise of each mode (ARM and LEG). HRV (including natural-logarithm of root-mean-square-of-successive-differences, Ln-RMSSD) and STI (including pre-ejection-period, PEP) were assessed throughout 10-min seated recovery. RESULTS Peak-HR was higher (p=0.001) during MAX-LEG (182±7beatsmin-1) compared with MAX-ARM (171±12beatsmin-1), while HR (p<0.001) and Ln-RMSSD (p=0.010) recovered more rapidly following MAX-ARM. PEP recovery was similar between maximal bouts (p=0.106). HR during submaximal exercise was 146±7 (LEG) and 144±8beatsmin-1 (LEG) (p=0.139). Recovery of HR and Ln-RMSSD was also similar between submaximal modalities, remaining below baseline throughout recovery (p<0.001). PEP was similar during submaximal exercise (LEG 70±6ms; ARM 72±9ms; p=0.471) although recovery was slower following ARM (p=0.021), with differences apparent from 1- to 10-min recovery (p≤0.036). By 10-min post-exercise, PEP recovered to baseline (132±21ms) following LEG (130±21ms; p=0.143), but not ARM (121±17ms; p=0.001). CONCLUSIONS Compared with submaximal lower-body exercise, HR-matched upper-body exercise elicited a similar recovery of HR and HRV indices of parasympathetic reactivation, but delayed recovery of PEP (reflecting sympathetic withdrawal). Exercise modality appears to influence post-exercise parasympathetic reactivation and sympathetic withdrawal in an intensity-dependent manner. These results highlight the need for test standardization and may be relevant to multi-discipline athletes and in clinical applications with varying modes of exercise testing.

Driving in an urban environment, the stress response and effects of exercise

Abstract Driving may be detrimental to health, with one hypothesis suggesting that driving may elicit an acute stress response and, with repeated exposures, may become a chronic stressor. The present study examined the stress response to driving and the effectiveness of a prior exercise bout in dampening this response. Twenty healthy adults performed three tasks: control, driving and exercise plus driving. Heart rate (HR), heart rate variability (HRV), blood pressure (BP) and cortisol were measured to quantify the acute stress response to each condition. Data indicated a stress response to driving: HR was elevated and HRV was reduced during the driving task compared with control. HR was elevated and HRV was reduced comparing the exercise plus driving with the driving condition. BP and cortisol were not different among conditions. The potential of interventions, such as exercise, to counter daily stressors should be evaluated to safeguard long-term health. Practitioner Summary: this study confirms that driving induces a stress response, with the exercise intervention providing mixed results (an increase in cardiovascular measures and a decrease in cortisol measure trending significance). Given the known consequences of stress and evidence that exercise can mitigate acute stress, further evaluation of exercise interventions is recommended.

A single session of hatha yoga improves stress reactivity and recovery after an acute psychological stress task—A counterbalanced, randomized-crossover trial in healthy individuals

OBJECTIVES Yoga is promoted as an anti-stress activity, however, little is known about the mechanisms through which it acts. The present study investigated the acute effects of a hatha yoga session, displayed on a video, on the response to and recovery from an acute psychological stressor. METHODS Twenty-four healthy young adults took part in a counterbalanced, randomized-crossover trial, with a yoga and a control condition (watching TV). Participants attended the laboratory in the afternoon on two days and each session comprised a baseline, control or yoga task, stress task and recovery. Blood pressure (BP), heart rate (HR) and salivary cortisol responses were measured. State cognitive- and somatic-anxiety along with self-confidence were assessed before and after the stressor. RESULTS Although no difference in the BP or HR responses to stress were found between conditions, systolic BP (p=0.047) and diastolic BP (p=0.018) recovery from stress were significantly accelerated and salivary cortisol reactivity was significantly lower (p=0.01) in the yoga condition. A yoga session also increased self-confidence (p=0.006) in preparation for the task and after completion. Moreover, self-confidence reported after the stress task was considered debilitative towards performance in the control condition, but remained facilitative in the yoga condition. CONCLUSION Our results show that a single video-instructed session of hatha yoga was able to improve stress reactivity and recovery from an acute stress task in healthy individuals. These positive preliminary findings encourage further investigation in at-risk populations in which the magnitude of effects may be greater, and support the use of yoga for stress reactivity and recovery.